重症监护中的工作量评分系统及其量化护理时间需求的能力：系统文献回顾。
Workload scoring systems in the Intensive Care and their ability to quantify the need for nursing time: A systematic literature review.
机构信息
Department Anesthesiology & Intensive Care, Isala, Dr. Van Heesweg 2, 8025 AB Zwolle, the Netherlands; National Intensive Care Evaluation, Postbus 23640, 1100 EC Amsterdam, the Netherlands.
National Intensive Care Evaluation, Postbus 23640, 1100 EC Amsterdam, the Netherlands; Department of Medical Informatics, Amsterdam UMC, Meibergdreef 9, 1105 AZ Amsterdam, the Netherlands.
出版信息
Int J Nurs Stud. 2020 Jan;101:103408. doi: 10.1016/j.ijnurstu.2019.103408. Epub 2019 Sep 17.
INTRODUCTION
The Intensive Care Unit is a resource intense service with a high nursing workload per patient resulting in a low ratio of patients per nurse. This review aims to identify existing scoring systems for measuring nursing workload on the Intensive Care and assess their validity and reliability to quantify the needed nursing time.
METHODS
We conducted a systematic review of the literature indexed before 01/Mar/2018 in the bibliographic databases MEDLINE, Embase, and Cinahl. Full-text articles were selected and data on systems measuring nursing workload on the Intensive Care and translation of this workload into the amount of nursing time needed was extracted.
RESULTS
We included 71 articles identifying 34 different scoring systems of which 27 were included for further analysis as these described a translation of workload into nursing time needed. Almost all systems were developed with nurses. The validity of most scoring systems was evaluated by comparing them with another system (59%) or by using time measurements (26%). The most common way to translate workload-scores into nursing time needed was by categorizing the Nurse:Patient-ratios. Validation of the Nurse:Patient-ratios was mostly evaluated by comparing the results with other systems or with the actual planning and not with objective time measurements.
CONCLUSION
Despite the large attention given to nursing workload systems for Intensive Care, only a few systems objectively evaluated the validity and reliability of measuring nursing workload with moderate results. The Nursing Activity Score system performed best. Poor methodology for the translation of workload scores into Nurse:Patient-ratio weakens the value of nursing workload scoring systems in daily Intensive Care practice.
简介
重症监护病房是一种资源密集型服务，每位患者的护理工作量都很高，导致护士与患者的比例很低。本综述旨在确定现有的重症监护护理工作量评分系统，并评估其有效性和可靠性，以量化所需的护理时间。
方法
我们对截至 2018 年 3 月 1 日之前在 MEDLINE、Embase 和 Cinahl 文献数据库中索引的文献进行了系统综述。选择全文文章，并提取有关在重症监护室测量护理工作量的系统以及将该工作量转化为所需护理时间的信息。
结果
我们共纳入 71 篇文章，确定了 34 种不同的评分系统，其中 27 种评分系统纳入进一步分析，因为这些评分系统描述了工作量向所需护理时间的转化。几乎所有系统都是由护士开发的。大多数评分系统的有效性是通过将其与另一个系统进行比较（59%）或通过使用时间测量来评估的（26%）。将工作量评分转化为所需护理时间的最常见方法是通过对护士：患者比例进行分类。护士：患者比例的验证主要通过将结果与其他系统或实际计划进行比较，而不是与客观的时间测量进行比较。
结论
尽管重症监护护理工作量系统受到了极大的关注，但只有少数系统客观地评估了测量护理工作量的有效性和可靠性，结果中等。护理活动评分系统表现最佳。将工作量评分转化为护士：患者比例的方法不佳，削弱了护理工作量评分系统在重症监护日常实践中的价值。
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